Writing Like a Doctor

June 09, 2009

I once asked my friend "Joe," a distinguished professor of history, how he taught his graduate students to write. He reminded me that I had sat in on his mini-lecture about the three different ways to begin an article or a book. Then he stopped talking and looked kind of pleased with himself.

"That's it?" I said.

Well, he stammered, he figured graduate students learned in some kind of osmotic process. They read a lot; surely while they did that they were picking up tips on how to write.

There were so many problems with that assumption that I think I probably started sputtering at that point. Having been an acquisitions editor of history books, I know as well as anyone that sometimes (often?) groundbreaking books with important arguments and exquisite research—field-changing books—are horrible examples of how to write. They end up being published, and read, but they should not serve as models.

The mere act of reading good books, if you are not stopping to scrutinize the moves and tools used by the writers, examining and dissecting the choices they have made and why they work, will do nothing for you when you sit down to write. If reading good literature was enough, I would have written the Great American Novel years ago.

A couple of summers ago, another friend of mine—let's call him "Godfrey"—an academic physician, had volunteered to drive with me from Spokane to Chicago, where he had to give a talk. I was en route to Upstate New York for the summer. Godfrey is a good friend. He is a fantastic conversationalist, a terrific athlete, and the best, smartest reader of my work. He is not, however, a great driver. When he gets wrapped up in talking, he forgets about driving and tends to slow to a traffic-jamming crawl.

Godfrey realized that he had three journal articles to finish. So after we'd done enough sightseeing through Montana and Wyoming and had a couple of small spats about where to get gas, we got to work. He drove. I had his computer on my lap. There was a half-eaten bag of Kettle Korn between us.

I started to read his manuscripts, and then made a few simple questions and comments: "Were you raised by wolves?" "How did you manage to graduate from such fancy-pants schools if you can't even write a sentence?" "Do you know what a sentence is?" "This is a comma." (Wild body gesture from the passenger seat.) "Learn what it does. You can't just sprinkle them on your prose like salt."

Whenever I ask Godfrey to explain his medical and scientific work to me—something I do frequently—I am captivated. He has the ability to get at the most interesting issues, to draw out the implications of what he's studying, and to explain them in ways that are fascinating. He knows how to tell a story in conversation. He knows which details will enhance suspense, which will come as a surprise.

But when it comes to putting it on the page, those skills desert him. He writes in simple, declarative, passive sentences. He endlessly repeats words and phrases. His language is complicated not only by terms of medical and scientific art, but by using unnecessary Latinate words when plain old Anglo-Saxon ones would do a better job. He has no idea how commas and paragraph breaks can be your friends, doesn't understand that adverbs are the refuge of the weak and lazy, and that semicolons, like loaded guns, should only be handled by those trained to use them.

In general, none of that has hurt Godfrey in his extensive publishing career. Having read a fair number of articles and grant proposals by his colleagues and peers, I would say he's no worse than most scientists and physicians, and better than many. Thankfully there are saintlike journal editors who follow in his wake to clean up the linguistic messes.

But there's something crucial here that often gets lost in academic writing (it's worse in fields like literary criticism and history). Because the work is so important to academics, sometimes they don't do a good job of convincing readers that they, too, should find it valuable. In many cases, the writer doesn't do a good enough job of explaining what the idea is, and then making the best argument for it.

When Godfrey told me that he'd had a manuscript rejected because the reviewers didn't get the importance of his findings, I explained that the failing was most likely his, not theirs. It's the burden of the writer to be clear and to let readers know why they should care. Far too many college freshmen start their papers: "In society today … ," and then make some simplistic suggestion. To them I say, why should I believe you? That is an assertion, not an argument. You have to show me your reasoning, help me follow your train of thought. The strongest and fairest writers make the best possible case for the other side, and then show how and why it's wrong. It's more convincing to knock down a strongman, rather than a strawman.

If you want a journal to accept your paper, or a federal agency to grant you coin, you have to make clear what is at stake and why the reader should care. Then you have to put forward the strongest reasoning based on evidence you provide in the clearest language you are able to rally. And then you need to know when you need help.

One of the hardest lessons I learned as a book editor is that the only good editing is the editing the author accepts. I could be brilliant in figuring out what was wrong with a manuscript, but if I couldn't sway the author, my work was worth nothing. If I couldn't explain to Godfrey the value of a semicolon, he was never going to learn how to use one. Calling him names, I knew, didn't help (but neither did it stop me—we've been good friends for a long time).

If graduate students in the humanities are not being taught how to write—how to structure an argument, how to make clear what is at stake, how to build tension on the sentence level—how can we expect those in the sciences to do any better? In every field there is an overabundance of content to master. Where do you steal the time in the curriculum to work on the form? The assumption is that whoever has gone before you in the teaching has already covered the basics. Graduate professors think that their students got it in their undergraduate years; composition instructors believe that they don't need to teach grammar because their students learned it in high school. How many students, do you think, are learning that an understanding of grammar, syntax, and usage is integral to clear expression of thoughts? That knowing how to write well is the most important skill you can develop, regardless of your career path?

Most students don't think about argumentation after they get their required freshman comp course out of the way. They take this important course when they are overwhelmed by the newness of college and are least ready to learn about the complexities of rhetorical strategies. Composition 101 is probably the hardest class to teach; unfortunately, it is usually led by brand-new graduate teaching assistants. It's no wonder most people don't know how to make an argument.

Many students also never absorb the importance of writing outlines. I was reminded of that while looking over the grant application of a pulmonologist friend. Even though I don't know him well, I didn't hold back: This is terrible, I said. The structure doesn't make any sense. It's repetitive and redundant. Did you write an outline? He told me he didn't have time to write an outline. I tried to be patient and to explain to him what he apparently never learned in school: An outline is a time-saving tool, not the exercise in busy work that it seemed in junior high.

When I was a book editor, I rejected the work of a multitude of physicians. While I was always interested in how doctors thought about their work, most of them couldn't get the job done when it came to the writing.

Even now, when I get letters from my own physician giving me the results of lab tests, I cringe. Can I really trust someone to interpret complicated data if she can't maintain control over her sentence structure? Communication is the fundamental element of most professions. Writing, as Plato reminded us, is a risky business. It should be approached with fear and trembling. Doctors and scientists might sometimes need a reminder that they are writing for humans.

Rachel Toor is an assistant professor of creative writing at Eastern Washington University, in Spokane. Her newest book is, "Personal Record: A Love Affair With Running," and her Web site is She welcomes comments and questions directed to